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Author
Topic: The business of HIV: Better drugs, but at high cost (Read 5581 times)

The coming weeks might bring a major victory in the long war against the human immunodeficiency virus, aka HIV, which causes AIDS. A drug called Truvada already treats the disease. By June 15, American regulators are expected to approve its use to prevent the transmission of HIV as well. The past 30 years have produced several triumphs. A flood of money has helped scientists to invent new drugs and helped health workers to deliver them to those in need. These drugs have transformed a fatal disease into a chronic one. They also have made HIV a big business. Sales of antiretroviral drugs in America and the five biggest European markets reached $13.3 billion in 2011, according to Datamonitor, a research company. The market is as unusual as it is large, both buoyed by government support and worryingly dependent on it. The past decade has brought fancier medicine in rich countries and copious aid for poor ones, but the war is far from won. Publicly funded research has played a larger role in developing drugs for HIV than for other diseases. A study published last year in Health Affairs found that HIV drugs are three times as likely to involve a patent from the public sector. HIV also has special status among regulators: America's Food and Drug Administration created a faster way to review HIV drugs, for example, allowing them on the market before the most expensive stage of clinical trials. In total, public and private investment has yielded more than two dozen HIV drugs. In 1987 Burroughs-Wellcome, now part of Glaxo Smith Kline, introduced the first one, tackling an enzyme that helps the virus progress inside human cells. In 1995 Hoffmann-La Roche, a Swiss drug firm, launched the first protease inhibitor, which interrupts the virus at a later stage of replication. Today different medicines are combined to suppress resistance or reduce side effects. The rise of combination therapy has brought a flurry of cross-licensing, as companies strike deals to sell each other's drugs in carefully calibrated cocktails. One company stands out: Gilead. A late entrant to the HIV race, the California firm quickly took the lead. Its strategy was simple: The more convenient the treatment, the better. In 2004 Gilead launched Truvada, a once-a-day, one-pill combination of two drugs. In 2006 it introduced Atripla, a once-a-day, one-pill combination of Truvada and another treatment. Atripla's average wholesale price in America is nearly $25,000 per patient, per year. In 2011 its global sales reached $3.2 billion. More good news for Gilead has come in recent weeks. An FDA panel recommended Truvada for preventive use, to protect healthy people from contracting the virus. Another FDA panel endorsed Gilead's new Quad pill, which is the simplest, most effective combination drug to date. If the process of developing HIV drugs has been unusual, selling them has been even more so. America is the rich world's biggest market, with 841,000 patients diagnosed. More than 60 percent of HIV drugs in America are bought with public money. Insurers give HIV special treatment, and patients are rarely pressed to buy the cheapest pills, as they might be if they had another disease. Distributing drugs in poor countries is harder. A decade ago hardly any poor people could afford them. At first drug companies handled this badly. In 1998, 39 big Western firms sued South Africa to protect their HIV patents. Global uproar ensued, and the firms backed down in 2001. Then two things changed. First, rich countries started donating vast sums to fight AIDS in poor ones. In 2000 there was less than $2 billion for HIV programs each year. By 2010 there was $15 billion, thanks to the Global Fund to Fight AIDS, Tuberculosis and Malaria and George W. Bush's President's Emergency Plan for AIDS Relief. Second, the price of AIDS drugs plunged. In May 2000, a year's "triple cocktail" therapy cost $10,000 or so. By 2011 the same pills sold for $62 in poor countries. The Plan for Aids Relief buys generic versions of patented drugs, which may be supplied only to poor countries. Can treatment expand further? Despite the subsidies and the plunge in prices, less than half of those infected with HIV take HIV drugs. Those who do, however, live a long time, and they have to keep taking the pills. What's more, new studies show that it helps to start treating patients early, so demand is sure to rise. Alas, aid dipped in 2009 and 2010 because of the financial crisis. To make matters more complicated, there is a trade-off between more drugs and better ones: Most patients in poor countries get outdated pills, according to Medecins Sans Frontieres. Allowing generics firms to copy even more patented drugs might help. Since 2006 Gilead has licensed drugs to generics firms for 5-percent royalties. Last year it went further, agreeing to license drugs to a "patent pool" to centralize royalty deals for a range of companies

big earnings for them but big sufferings for us. why can they make it cheaper if they really wany to help. just thinking, in IT world, virus was made to boost earnings of anti-virus software companies.

big earnings for them but big sufferings for us. why can they make it cheaper if they really wany to help. just thinking, in IT world, virus was made to boost earnings of anti-virus software companies.

Cockamamie conspiracy theorist, much? There is a LOT of malware out there that was certainly NOT created by the couple of anti-virus software companies turning a profit.

And HIV was not INVENTED or SPREAD by the US Government, the US Military, Evil Big Pharma, the Masons, the Illuminati, White Supremacist Mad Scientists in 1969 as recounted by Louis Farrakan, God - in order to punish hell-bound ho..mo..sex..sicles, the World Bank, the Mellon Bank, the Jewish Cabal, the royal House of Saud, or Karl Lagerfeld.

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“From each, according to his ability; to each, according to his need” 1875 K Marx

Cockamamie conspiracy theorist, much? There is a LOT of malware out there that was certainly NOT created by the couple of anti-virus software companies turning a profit.

And HIV was not INVENTED or SPREAD by the US Government, the US Military, Evil Big Pharma, the Masons, the Illuminati, White Supremacist Mad Scientists in 1969 as recounted by Louis Farrakan, God - in order to punish hell-bound ho..mo..sex..sicles, the World Bank, the Mellon Bank, the Jewish Cabal, the royal House of Saud, or Karl Lagerfeld.

youre right , not all virus was made by software companies, but surely they made one of those malwares surfing around the net, if you dont extend or renew your 1 year term with their software, youll never get the updates for new viruses, so youre required to buy again. but i never posted that hiv was created nor spread by blah blah lol. just business as usual cheers

OK then. I clearly didn't understand the analogy I thought you were making. See I thought you were saying anti-virus companies make viruses so you keep buying the anti-virus. And this is related to HIV because.... because? What is your analogy? Because Big Pharma or someone made the virus to make money treating it?? Or someone (Big Pharma?) isn't curing HIV because then they won't make money?

Just spell it out. Don't hedge. I am confused by your post. You posted a long, rather illegible (no paragraphs) article, and finally just your own short comment consisting entirely of this analogy (which I guess I so completely misunderstood).

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“From each, according to his ability; to each, according to his need” 1875 K Marx

Because Big Pharma or someone made the virus to make money treating it?? Or someone (Big Pharma?) isn't curing HIV because then they won't make money?

no but they are delaying a cure as much as possible. the lack of funding is an evidence. they put more money in the research of new drugs with the same or with similar chemical compounds and principles of action. only a couple of drugs act differently as others. they never developed drugs able to reach the lymph nodes or other sites where the virus hides. now with the evidence of a cure provided by the berlin patient something is starting to roll but funds are still lacking. please go on the aids policy project page. the nih is refusing to increase the funding for a cure.

also, pharma companies are developing new drugs (f.e. the tenofovir prodrug and viramune xr) to delay patent expirations and the impact this will have on their stock value. this are not the thoughts of some paranoid wackos but it is a reality. the quad pill for example is nothing else that a new drug (a combination of different drugs) for beginners since the most revenues are expected from this patients in part due to an earlier start of therapy according to the new guidelines. for those with resistance issues this new pill is quite useless.

« Last Edit: July 06, 2012, 09:38:27 PM by xman »

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sign the petition launched by the aids policy project addressed to the nih aimed to increase the money needed to find the cure:

And HIV was not INVENTED or SPREAD by the US Government, the US Military, Evil Big Pharma, the Masons, the Illuminati, White Supremacist Mad Scientists in 1969 as recounted by Louis Farrakan, God - in order to punish hell-bound ho..mo..sex..sicles, the World Bank, the Mellon Bank, the Jewish Cabal, the royal House of Saud, or Karl Lagerfeld.

But I still do not buy the monkey theory, no matter how many people say it...it seems really really random and far-fetched. I still think the virus was created in lab, I don't know by whom or for which purpose but I still think its funny (as in, ridiculous) that there is such a deadly virus out there that was spread mainly by anal sex.

But I still do not buy the monkey theory, no matter how many people say it...it seems really really random and far-fetched. I still think the virus was created in lab, I don't know by whom or for which purpose but I still think its funny (as in, ridiculous) that there is such a deadly virus out there that was spread mainly by anal sex.

HIV has infected over 30 million people. Most of whome were NOT infected through anal sex.

Maybe you should learn about the disease you have before making such comments

no but they are delaying a cure as much as possible. the lack of funding is an evidence. they put more money in the research of new drugs with the same or with similar chemical compounds and principles of action. only a couple of drugs act differently as others. they never developed drugs able to reach the lymph nodes or other sites where the virus hides. now with the evidence of a cure provided by the berlin patient something is starting to roll but funds are still lacking. please go on the aids policy project page. the nih is refusing to increase the funding for a cure.

also, pharma companies are developing new drugs (f.e. the tenofovir prodrug and viramune xr) to delay patent expirations and the impact this will have on their stock value. this are not the thoughts of some paranoid wackos but it is a reality. the quad pill for example is nothing else that a new drug (a combination of different drugs) for beginners since the most revenues are expected from this patients in part due to an earlier start of therapy according to the new guidelines. for those with resistance issues this new pill is quite useless.

By your logic, if new drugs under new patents, because its a new combination, are just old drugs that are about to lose patents, then doctors have an option to prescribe patent free medicine. More and more generics will be available in the first world in the next few years. You realise that when Atripla was approved in the USA, it was over a year later that it was approved in Switzerland. My ID doc just prescribed the identical drugs and I took 2 pills instead of 1.

Your arguments are scattered, woefully under researched, and NO sources. If this were a research report, and I were the evaluator, I'd make you footnote everything from peer review research! Bad boy!

Exactly what virus has ever been cured by Big Pharma, by the way?? Oh, and you do realise that research universities and national research institutes all over the developed world, and even in developing countries, are involved in HIV research. Intellectually independent from your hypothesized evil Big Pharma.

Yes, you are correct. Big Pharma wants big profit. Thats called capitalism. You don't put any of your theories into the context of a much more complex global system. For example, much of the drug therapy now available in many developing and underdeveloped countries is on special pricing permits from your evil Big Pharma or in some instances just produced completely ignoring Big Pharma. Are you now a specialist in patent law, and international trade, and the global economy, to explain how Big Pharma is able to control all of this to its own interests? Frankly, it is NOT able to. One reason they finally cried mea culpa and priced drugs according to a country's ability to pay. Sure, they are reaping untold billions in profit from the rich countries. Agreed. Small point really. Hardly enough for your sweeping generalizations.

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“From each, according to his ability; to each, according to his need” 1875 K Marx

I only speak in tongues after a few glasses of white zin. Thank goodness for that southern baptist upbringing with an added twist of Catholicism.

But yes, I'm only being flippant because I've heard and read these ridiculous theories for so long that I have to find humor in them. I'm from a part of the world where it's not difficult to convince people that MSM is men who have sex with monkeys....

But I still do not buy the monkey theory, no matter how many people say it...it seems really really random and far-fetched. I still think the virus was created in lab, I don't know by whom or for which purpose but I still think its funny (as in, ridiculous) that there is such a deadly virus out there that was spread mainly by anal sex.

I only speak in tongues after a few glasses of white zin. Thank goodness for that southern baptist upbringing with an added twist of Catholicism.

But yes, I'm only being flippant because I've heard and read these ridiculous theories for so long that I have to find humor in them. I'm from a part of the world where it's not difficult to convince people that MSM is men who have sex with monkeys....

Oh thank god. How did I even question if it was sarcasm or not. But, like you, I get flabbergasted in threads like these.

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“From each, according to his ability; to each, according to his need” 1875 K Marx

I think this thread has proved within a shadow of a doubt you shouldn't have anal sex with monkeys . Personally I have never done it but the ones who do ... and you know who you are really need to stop or at least cut down on it .

I think this thread has proved within a shadow of a doubt you shouldn't have anal sex with monkeys . Personally I have never done it but the ones who do ... and you know who you are really need to stop or at least cut down on it .

By your logic, if new drugs under new patents, because its a new combination, are just old drugs that are about to lose patents, then doctors have an option to prescribe patent free medicine. More and more generics will be available in the first world in the next few years. You realise that when Atripla was approved in the USA, it was over a year later that it was approved in Switzerland. My ID doc just prescribed the identical drugs and I took 2 pills instead of 1.

Your arguments are scattered, woefully under researched, and NO sources. If this were a research report, and I were the evaluator, I'd make you footnote everything from peer review research! Bad boy!

Exactly what virus has ever been cured by Big Pharma, by the way?? Oh, and you do realise that research universities and national research institutes all over the developed world, and even in developing countries, are involved in HIV research. Intellectually independent from your hypothesized evil Big Pharma.

Yes, you are correct. Big Pharma wants big profit. Thats called capitalism. You don't put any of your theories into the context of a much more complex global system. For example, much of the drug therapy now available in many developing and underdeveloped countries is on special pricing permits from your evil Big Pharma or in some instances just produced completely ignoring Big Pharma. Are you now a specialist in patent law, and international trade, and the global economy, to explain how Big Pharma is able to control all of this to its own interests? Frankly, it is NOT able to. One reason they finally cried mea culpa and priced drugs according to a country's ability to pay. Sure, they are reaping untold billions in profit from the rich countries. Agreed. Small point really. Hardly enough for your sweeping generalizations.

i wrote another thread with a financial analisys of the coming decade. I post the link below:

from that report you can clearly see that the research is more therapy oriented. the quad pill will dominate the market.

according to an article from the last croi only 2 big pharma companies, gilead and merck, are actively searching for compounds able to rid the reservoirs. excluding the small bio pharmaceutical companies, what are the other companies doing?

this 2 companies will certainly level their budgets for cure research taking in consideration the revenues from their actual leading products in therapy, especially gilead which has one drug recently approved in a combination, and is launching the quad pill.

the nih is spending only 3% of their actual aids budget on a cure. the remaining 97% is for treatment, prevention and vaccine research. you can read it on the aids policy project page.http://www.aidspolicyproject.org/i guess that you didn't sign yet their petition for an increase of funds from the nih to speed up the research for a cure. i certainly did.

universities and national research centers don't have enough funds to accelerate their research or to create the logistics for a broad distribution of their products. market is dominated by corporations and not by public organizations.

« Last Edit: July 10, 2012, 11:23:03 AM by xman »

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sign the petition launched by the aids policy project addressed to the nih aimed to increase the money needed to find the cure:

Ok man, I'm going to respect your rigor and concede you make some good points as to what to expect from profit making Big Pharma. I'm not the one to defend the excesses of capitalism - see my tagline since the day I joined here. We know too big to fail banks are corrupt to the core and are looking out for only a very few people. So why not Big Pharma, as well. Just as long as there are not the crazy ass conspiracies attached onto such business analyses. Also, many holes in the overall argument that so few companies and therefore just a handful of directors have the power to control all scientific research into HIV and into the cure for HIV. Also, perhaps some impatience on your part as to the feasibility of curing any virus. Question - is the glass half full, or half empty? Do we marvel at the unprecedented science that has made this killer "manageable." Or are we currently victims of big pharma capitalism, mere pawns, to the profits of a few companies. Overall, I don't buy your glass half-empty scenario.

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“From each, according to his ability; to each, according to his need” 1875 K Marx

The people that buy into the big pharma conspiracy theory's need to realize that the drug company's are just one cog in the wheel . For drug company's to get away with something like what has been suggested many other research facility's would have to be complacent or not doing research in earnest . Take a look at some of what goes on at a local hospital in my community and you must admit that the doctors and researchers care deeply for what and whom they are doing this kind of work for .

Polio is a virus and it's been virtually eradicated with a vaccine. (The only reason it hasn't yet been eradicated is because not all children around the world are being vaccinated, mainly in developing nations where infant health care is poor.)

I'm sure there are others, but those are the only two I can think of off the top of my head.

I think this thread has proved within a shadow of a doubt you shouldn't have anal sex with monkeys . Personally I have never done it but the ones who do ... and you know who you are really need to stop or at least cut down on it .

Jonathan often talks about "hot monkey sex". I always gave him the benefit of doubt and assumed he was talking about hot monkey sex with his human boyfriends, but one never knows.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

I forget about Hep C because a good friend of mine is losing this battle. He got Hep C and HIV in the 80's and limped into the HAART era and got the lazarus effect. But Hep C treatments to date have been destructive, and not curative. He's going to try again starting August but the prognosis is not good....

As for the Polio, OK prevented by vaccine, but there is no treatment, nor cure.

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“From each, according to his ability; to each, according to his need” 1875 K Marx